CARDIAC MODULATION BY EXERCISE IN A PATIENT WITH DECOMPENSATED HEART FAILURE - CASE REPORT

• Main Authors: Bruno Delgado, Ivo Lopes, Eugénia Mendes, Leonel Preto, Bárbara Gomes, André Novo
• Format: Article
• Language: English
• Published: Associação Portuguesa dos Enfermeiros de Reabilitação 2019-12-01
• Series: Revista Portuguesa de Enfermagem de Reabilitação
• Subjects: breathing exercises; bacterial pneumonia; rehabilitation nursing; case reports
• Online Access: https://rper.aper.pt/index.php/rper/article/view/142

Introduction: Patients with decompensated heart failure are characterized by low exercise tolerance associated with dyspnea and edema. Exercise training promotes exercise tolerance as well as an improvement in ventricular function. Objective: To identify signs of cardiac modulation and consequent improvement of functional capacity after the implementation of a structured exercise plan. Method: Quantitative approach case report. Patient with decompensated heart failure of ischemic and valvular etiology, manifesting a high degree of activity intolerance as well as hemodynamic decompensation. Physiological parameters such as Heart Rate, Blood Pressure, Subjective perception of effort evaluated by the Borg scale and the tolerance of the patient to activity at baseline and throughout the training sessions. The 6MWT was applied at two different moments: on the 4th day of hospitalization and at discharge, as a way to evaluate the evolution of functional capacity. This patient is enrolled on randomized clinical trial that aims to evaluate the feasibility and safety of exercise, being used as assessment tools the LCADL scale, the Barthel Index, as well as the 6MWT. Results: There was an improvement in the patient’s functional capacity, assessed by the 6-minute walk test (T1: 210m, T2: 295m), as well as a reduction in resting heart rate (85 bpm vs 68 bpm) and training heart rate (145bpm vs 94bpm). No adverse events occured during training sessions. Conclusions: The intervention implemented in this clinical situation proved to be safe and equally effective in improving functional capacity and modulating heart rate at rest and during exercise training.